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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE SCHILLING</PersonNm>
        <TitleTxt>DIRECTOR, SECRETARY BEG 06/19</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CINDY SHARPE</PersonNm>
        <TitleTxt>DIRECTOR BEG 12/19</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MIKE MAUZY</PersonNm>
        <TitleTxt>TREASURER END 6/19</TitleTxt>
        <AverageHoursPerWeekRt>1.0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1766632</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>272475</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>21</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>PAIN CENTERS OF IOWA</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5515 UTICA RIDGE ROAD 600</AddressLine1Txt>
            <CityNm>DAVENPORT</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52807</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTH SERVICES</ServicesDesc>
        <CompensationAmt>383185</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>GREAT RIVER JANITORIAL</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>606 BROADWAY</AddressLine1Txt>
            <CityNm>WEST BURLINGTON</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>52655</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICES</ServicesDesc>
        <CompensationAmt>152042</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>NEXTGEN</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1811 VON KARMAN AVE STE 800</AddressLine1Txt>
            <CityNm>IRVINE</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92612</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE SUPPORT</ServicesDesc>
        <CompensationAmt>146263</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>QUEST DIAGNOSTICS</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 775460</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606775460</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTH SERVICES</ServicesDesc>
        <CompensationAmt>103652</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>4</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2908922</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>390784</AllOtherContributionsAmt>
      <TotalContributionsAmt>3299706</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>16821516</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16821516</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>38487</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>38487</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>16860003</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>28523</TotalRevenueColumnAmt>
        <ExclusionAmt>28523</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
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      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
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        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <GrossAmountSalesAssetsGrp>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>3700</ExclusionAmt>
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      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>GAIN ON INV IN EQUITY INVESTEE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>47953</TotalRevenueColumnAmt>
        <ExclusionAmt>47953</ExclusionAmt>
      </OtherRevenueMiscGrp>
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        <RelatedOrExemptFuncIncomeAmt>16860003</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>80176</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
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      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
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      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>515733</ProgramServicesAmt>
        <ManagementAndGeneralAmt>286413</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
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      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
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        <ProgramServicesAmt>5978802</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2609569</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>222846</ProgramServicesAmt>
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        <ProgramServicesAmt>875585</ProgramServicesAmt>
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        <ProgramServicesAmt>443371</ProgramServicesAmt>
        <ManagementAndGeneralAmt>196178</ManagementAndGeneralAmt>
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      <FeesForServicesManagementGrp>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>17494</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>97402</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>1653805</ProgramServicesAmt>
        <ManagementAndGeneralAmt>320256</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>6513</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3958</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>446664</ProgramServicesAmt>
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      <InformationTechnologyGrp>
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      <RoyaltiesGrp>
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        <ProgramServicesAmt>187020</ProgramServicesAmt>
        <ManagementAndGeneralAmt>124976</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>9423</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29471</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
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      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>34243</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12921</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>71561</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28173</ManagementAndGeneralAmt>
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      <PaymentsToAffiliatesGrp>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>284402</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>50921</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34152</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUGS</Desc>
        <TotalAmt>1383052</TotalAmt>
        <ProgramServicesAmt>1352818</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30234</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
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        <ProgramServicesAmt>746882</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSES, DUES, SUBSCRIPTIONS</Desc>
        <TotalAmt>101745</TotalAmt>
        <ProgramServicesAmt>35384</ProgramServicesAmt>
        <ManagementAndGeneralAmt>66361</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>71197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10522</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>18009946</TotalAmt>
        <ProgramServicesAmt>12987170</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5022776</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>257126</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>3454379</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>62284</EOYAmt>
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        <EOYAmt>1687340</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>201589</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>71370</EOYAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>7311625</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>173326</EOYAmt>
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        <EOYAmt>595415</EOYAmt>
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        <EOYAmt>3948105</EOYAmt>
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        <EOYAmt>11673305</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>15621410</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>2229939</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="IRS990ScheduleA">
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        <CurrentTaxYearMinus3YearsAmt>2708922</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3916957</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3213276</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3299706</CurrentTaxYearAmt>
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        <CurrentTaxYearMinus1YearAmt>5069</CurrentTaxYearMinus1YearAmt>
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    <IRS990ScheduleB documentId="IRS990ScheduleB">
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        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1(I)</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), THE IOWA PRIMARY CARE ASSOCIATION (IAPCA), AND THE ILLINOIS PRIMARY HEALTHCARE ASSOCIATION (ILPHCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
        <OtherCostOrOtherBasisAmt>223943</OtherCostOrOtherBasisAmt>
        <BookValueAmt>223943</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>8230540</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2044452</DepreciationAmt>
        <BookValueAmt>6186088</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>247158</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>218415</DepreciationAmt>
        <BookValueAmt>28743</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2084291</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1456811</DepreciationAmt>
        <BookValueAmt>627480</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>812458</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>567087</DepreciationAmt>
        <BookValueAmt>245371</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>7311625</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM THIRD PARTY PAYERS</Desc>
        <BookValueAmt>1670700</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER RECEIVABLES</Desc>
        <BookValueAmt>136256</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>457(B) ASSETS</Desc>
        <BookValueAmt>595415</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>2402371</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <Amt>595415</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>595415</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>19372808</TotalRevEtcAuditedFinclStmtAmt>
      <DonatedServicesAndUseFcltsAmt>36000</DonatedServicesAndUseFcltsAmt>
      <OtherRevenueAmt>-746882</OtherRevenueAmt>
      <RevenueNotReportedAmt>-710882</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>20083690</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>156195</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>156195</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>20239885</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>17295364</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>36000</DonatedServicesUseFcltsAmt>
      <OtherExpensesIncludedAmt>-3700</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>32300</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>17263064</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>746882</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>746882</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>18009946</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VII, LINE 12: $ (746,882) BAD DEBT EXPENSE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XI, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 152,495 TEMPORARILY RESTRICTED CONTRIBUTIONS 3,700 GAIN ON SALE OF ASSETS ------------ $ 156,195</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON LINE 1, BUT NOT ON PART FORM 990, PART IX, LINE 25: $ ( 3,700) GAIN ON SALE OF ASSETS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART XII, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 746,882 BAD DEBT EXPENSE</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RONALD KEMP</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>131245</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1334</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6491</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7170</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14118</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>160358</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN BRADY</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>255174</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1450</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>12235</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>268859</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LUCAS LEMBURG</PersonNm>
        <TitleTxt>CDO</TitleTxt>
        <BaseCompensationFilingOrgAmt>198689</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>9555</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10730</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27900</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>246874</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALISHA BASSLER</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>153248</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>7035</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8337</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27996</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>196616</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES DEMMEL</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>228056</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>34115</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13398</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27403</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>302972</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK STROPE</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>9230</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10275</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12338</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>226214</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHAILESH DESAI</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>251150</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>10500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7142</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26961</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>295753</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TESSA JOHNSON</PersonNm>
        <TitleTxt>DENTIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>170984</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>9130</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9251</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26041</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>215406</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION OFFERS A WELLNESS PROGRAM TO ITS EMPLOYEES WHICH PROVIDES DIRECT REIMBURSEMENT OF UP TO $25 PER MONTH AFTER THE EMPLOYEES HAVE USED THE GYM OR WEIGHT WATCHERS PROGRAM THREE TIMES DURING THE MONTH. EMPLOYEE MUST SHOW DOCUMENTATION OF PAYMENT OF FEES AND ATTENDANCE. IF ATTENDANCE IS LESS THAN THREE TIMES A MONTH, NO PAYMENT IS MADE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>NON-FIXED PAYMENTS: BONUS AMOUNTS PAID ARE BASED ON PRODUCTION LEVELS AND QUALITY MEASURES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>VOLUNTEERS: THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>ORGANIZATION'S MISSION: CHCSEIA IS A FEDERALLY QUALIFIED HEALTH CENTER WHOSE MISSION IS TO PROVIDE AFFORDABLE, COMPREHENSIVE, CULTURALLY APPROPRIATE, COST EFFECTIVE HEALTH CARE TO RESIDENTS OF THE GREATER SOUTHEASTERN IOWA REGION IN ORDER TO IMPROVE THEIR OVERALL HEALTH STATUS. THE MAIN PURPOSES OF THE ORGANIZATION ARE THE FOLLOWING: -PROVIDE PRIMARY MEDICAL CARE, GENERAL DENTAL SERVICES, AND INTEGRATED BEHAVIORAL HEALTH SERVICES -CREATE NEW HEALTH CARE RESOURCES AND HEALTH CARE ARRANGEMENTS TO OFFER TO THE COMMUNITIES SERVED BY THE CORPORATION -EXPAND ACCESS TO HEALTH CARE TO THOSE INDIVIDUALS UNABLE TO OBTAIN ADEQUATE HEALTH CARE -REDUCE UNNECESSARY DUPLICATION OF SERVICES, TECHNOLOGY AND FACILITIES BY COORDINATING THE DELIVERY OF HEALTH CARE SERVICES ON A COST-EFFECTIVE BASIS -CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED OR THE PROMOTION OR HEALTH WHICH MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER REQUIREMENTS THAT ARE OR CAN BE MADE AVAILABLE -PROMOTE AND CARRY ON SPECIAL RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED INSOFAR AS SAID RESEARCH CAN BE CARRIED ON, OR IN CONNECTION WITH, THE FACILITIES AND PROGRAMS OPERATED BY THIS CORPORATION -TAKE AND HOLD BY BEQUEST, DEVISE, GIFT, GRANT, PURCHASE, LEASE OR OTHERWISE ANY PROPERTY, REAL, PERSONAL, TANGIBLE OR INTANGIBLE, OR ANY UNDIVIDED INTEREST THEREIN, WITHOUT LIMITATION AS TO AMOUNT OR VALUE -SELL, CONVEY OR TO OTHER DISPOSE OF ANY SAID PROPERTY AND INVEST, REINVEST, OR DEAL WITH THE PRINCIPAL OR THE INCOME THEREOF IN SAID MANNER AS, IN THE JUDGEMENT OF THE DIRECTORS OF THIS CORPORATION, WILL BEST PROMOTE THE PURPOSES OF THE CORPORATION WITHOUT LIMITATION, EXCEPT SUCH LIMITATIONS, IF ANY AS MAY BE CONTAINED IN THE INCORPORATION, THE BYLAWS OF THE CORPORATION, OR ANY OTHER LAWS THERETO APPLICABLE. -RAISE GIFTS, BEQUESTS, DONATIONS, AND OTHER FUNDS FROM THE PUBLIC AND FROM ALL OTHER SOURCES AVAILABLE, RECEIVE AND MAINTAIN SUCH FUNDS AND EXPEND PRINCIPAL AND INCOME THERE FROM IN SUPPORT OF OR IN FURTHERANCE OF THE CHARITABLE PURPOSES OF THE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR, THE COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA MADE THE FOLLOWING CHANGES TO THE BYLAWS OF THE ORGANIZATION: SECTION 1: GENERAL POWERS THE GOVERNING BOARD FOR THE CENTER SHALL HAVE AUTHORITY FOR THE ESTABLISHMENT OF POLICY IN THE CONDUCT OF THE CENTER. THE GOVERNING BOARD SHALL HOLD REGULARLY SCHEDULED MEETINGS FOR WHICH MINUTES SHALL BE KEPT. THE GOVERNING BOARD SHALL HAVE SPECIFIC ULTIMATE AND AUTONOMOUS AUTHORITY FOR THE FOLLOWING: 1. HIRING, ANNUALLY EVALUATING, AND DISMISSING THE CHIEF EXECUTIVE OFFICER (CEO). 2. DEVELOPING, ADOPTING, AND PERIODICALLY UPDATING THE HEALTH CENTER'S PERSONNEL POLICIES AND PROCEDURES, INCLUDING BUT NOT LIMITED TO: A. SELECTION AND DISMISSAL PROCEDURE B. SALARY AND BENEFIT SCALES C. EMPLOYEE GRIEVANCE PROCEDURES D. EQUAL OPPORTUNITY PRACTICES 3. EVALUATING HEALTH CENTER ACTIVITIES, INCLUDING: A. SERVICE UTILIZATION PATTERNS B. PRODUCTIVITY C. PATIENT SATISFACTION D. ACHIEVEMENT OF PROJECT OBJECTIVES E. DEVELOPING A PROCESS FOR HEARING AND RESOLVING PATIENT GRIEVANCES F. RISK MANAGEMENT, PATIENT SAFETY AND ONGOING QUALITY IMPROVEMENT PROCESSES 4. DEVELOPING, ADOPTING, AND PERIODICALLY UPDATING CENTER POLICIES FOR FINANCIAL MANAGEMENT PRACTICES, INCLUDING: A. A SYSTEM TO ASSURE ACCOUNTABILITY FOR CORPORATE RESOURCES B. LONG-RANGE FINANCIAL PLANNING C. APPROVAL OF THE ANNUAL PROJECT BUDGET SUBMITTED AS PART OF THE 330 GRANT APPLICATION AND THE ANNUAL BUDGET PROCEDURES D. BUDGETING PRIORITIES E. ELIGIBILITY FOR SERVICES, INCLUDING CRITERIA FOR PARTIAL PAYMENTS SCHEDULES 5. DEVELOPING, ADOPTING, AND PERIODICALLY UPDATING HEALTH CENTER HEALTH POLICIES, INCLUDING: A. SCOPE AND AVAILABILITY OF SERVICES B. LOCATION OF HOURS AND SERVICES C. UNDERTAKING A QUALITY OF CARE AUDIT 6. ASSURING THAT HEALTH CENTER ACTIVITIES ARE CONDUCTED IN COMPLIANCE WITH APPLICABLE FEDERAL, STATE, AND LOCAL LAWS. 7. EVALUATING HEALTH CENTER ACHIEVEMENTS AT LEAST ANNUALLY, AND USING THE KNOWLEDGE GAINED TO REVISE ITS MISSION, GOALS, OBJECTIVES, PLANS AND BUDGETS AS MAY BE APPROPRIATE AND NECESSARY. 8. SELECTING THE INDEPENDENT AUDITOR AND OFFICIALLY ACCEPTING THE ANNUAL AUDIT REPORT. 9. EVALUATING ITSELF PERIODICALLY FOR EFFICIENCY, EFFECTIVENESS, AND COMPLIANCE WITH ALL SECTION 330 REQUIREMENTS. 10. IT IS SPECIFIED THAT NO THIRD PARTY(IES) INCLUDING ANY CORPORATE MEMBERS, MAY BE GRANTED APPROVAL OR VETO RIGHTS REGARDING ANY OF THE AFOREMENTIONED AUTHORITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED, THE RETURN IS REVIEWED BY THE ORGANIZATION'S CEO AND CFO. IT IS THEN PROVIDED TO THE BOARD FOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY: A. GENERAL PRINCIPLES PROHIBITING CONFLICTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF CHC/SEIA WILL PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT (SUPPORTED BY FEDERAL FUNDS) IF A REAL OR APPARENT CONFLICT OF INTEREST WOULD BE INVOLVED. SUCH A CONFLICT WOULD ARISE WHEN THE EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER, OR ANY MEMBER OF HIS OR HER IMMEDIATE FAMILY, HIS OR HER PARTNER, OR AN ORGANIZATION WHICH EMPLOYS OR IS ABOUT TO EMPLOY ANY OF THE PARTIES INDICATED HEREIN, HAS A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD. B. CONFLICTS OF INTEREST AND DISCLOSURE REQUIREMENTS: NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER OR BOARD MEMBER WILL HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST IN, OR RECEIVE ANY COMPENSATION OR OTHER BENEFITS AS A RESULT OF, TRANSACTIONS BETWEEN CHC/SEIA AND ANY INDIVIDUAL OR BUSINESS FIRM WITHOUT DISCLOSING THE CONFLICT OF INTEREST. NO EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS MAY PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT OR GRANT IN WHICH FEDERAL FUNDS ARE USED, IF THEY HAVE A FINANCIAL OR OTHER INTEREST IN THE FIRM SELECTED FOR THE CONTRACT OR AWARD WITHOUT DISCLOSING THE CONFLICT OF INTEREST. IF AN EMPLOYEE, CONTRACTOR, AGENT, OFFICER, OR MEMBER OF THE BOARD OF DIRECTORS BELIEVES THAT ONE OF THE AFOREMENTIONED CONFLICTS ACTUALLY OR POTENTIALLY EXISTS, HE OR SHE MUST IMMEDIATELY DISCLOSE THIS INFORMATION IN WRITING TO THE CEO. DISCLOSURES BY MEMBERS OF THE BOARD OF DIRECTORS MUST ALSO BE MADE TO THE CHAIR OF THE BOARD OF DIRECTORS (AND IF IT IS THE CEO OR THE CHAIR WHO HAS SUCH A FINANCIAL INTEREST, HE OR SHE MUST MAKE DISCLOSURE TO THE CHAIR OR VICE CHAIR, RESPECTIVELY). THE CHC/SEIA REQUIRES THAT ALL EMPLOYEES, CONTRACTORS, AGENTS, OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS AND CANDIDATES FOR BOARD MEMBERSHIP DISCLOSE IN WRITING (AND UPDATE AT LEAST ANNUALLY) AT OR AROUND THEIR JANUARY MEETING: - ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH CREATE AN ACTUAL OR POTENTIAL A CONFLICT OF INTEREST, AND - WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. TO FACILITATE DISCLOSURE, CHC/SEIA REQUIRES EMPLOYEES, CONTRACTORS, AGENTS) OFFICERS AND BOARD MEMBERS TO COMPLETE A CHC/SEIA CONFLICT OF INTEREST FORM. COMPLETION THE FORM DOES NOT RELIEVE INDIVIDUALS OF THE OBLIGATION TO NOTIFY THE CEO OR BOARD CHAIR IF CHANGES OCCUR SINCE FILING OF THE FORM REGARDING A NEW CONFLICT OF INTEREST. NO MEMBER OF THE BOARD OF DIRECTORS MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL OR OTHER GAIN TO THAT MEMBER, OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS OR TO HIS OR HER EMPLOYER. PROVIDED THAT THE MEMBER OF THE BOARD OF DIRECTORS HAS FIRST DISCLOSED A CONFLICT OR POTENTIAL CONFLICT, AND ABSTAINS FROM VOTING IN THAT REGARD, HE OR SHE MAY PARTICIPATE IN DISCUSSIONS RELATING TO THAT MATTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION REVIEW: DURING FISCAL YEAR 2020, THE CEO, CFO, AND BOARD APPROVED RATES USING SALARY SURVEYS FOR COMPARABLE POSITIONS FORM THE IAPCA, ILPHCA, NACHC, IOWA WORKFORCE AND OTHER SOURCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC EXCEPT IN CASES WHERE IT IS REQUIRED BY LAW. FINANCIAL STATEMENTS ARE ONLY RELEASED FOR ACTIVITIES THAT ARE DEEMED NECESSARY FOR BONA FIDE BUSINESS PURPOSES, SUCH AS LOANS, OR IN CASES WHERE IT IS REQUIRED BY LAW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1067273</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONTRACT SERVICES TOTAL FEES:483566</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:HIT EXPENSE TOTAL FEES:309760</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER CONTRACTUAL FEES TOTAL FEES:95275</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONSULTING FEES TOTAL FEES:18187</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>